| Clinical reinfarction according to infarct location and reperfusion modality in patients with ST elevation myocardial infarction. A DANAMI-2 long-term follow-up substudy. | |
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MedLine Citation:
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PMID: 19005253 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: To evaluate clinical reinfarction during a 3-year follow-up after randomization to primary angioplasty versus fibrinolysis in anterior and non-anterior ST elevation myocardial infarction (STEMI). METHODS: Clinical reinfarction was prospectively assessed by an endpoint committee blinded to the study treatment. RESULTS: At 30 days, primary angioplasty compared with fibrinolysis reduced the reinfarction rate both in anterior STEMI patients (n = 823; 2.5 vs. 5.6%, p = 0.02) and in non-anterior STEMI patients (n = 743; 0.8 vs. 7.4%, p < 0.001). After 3 years, the reduction in reinfarction rate was no longer present in anterior STEMI patients (11.2 vs. 11.2%, p = 0.86), but persisted in non-anterior STEMI patients (5.2 vs. 13.5%, p < 0.001). Reinfarction after anterior STEMI carried a higher mortality than reinfarction after non-anterior STEMI (37.6 vs. 15.3%, p = 0.01). Independent predictors of death were: age [hazard ratio (HR) per 1-year increase in age = 1.08 (1.07-1.09)], clinical reinfarction [HR = 5.15 (3.57-7.43)], anterior index STEMI [HR = 1.65 (1.24-2.19)], and Killip class > or =2 [HR = 1.42 (1.01-2.00)]. The additional late reinfarctions after angioplasty for anterior STEMI were located within the angioplasty-treated target segment. Anterior STEMI patients had smaller mean target vessel diameter, which was associated with reinfarction. CONCLUSIONS: Clinical reinfarction is an independent predictor of death. The early superiority of primary angioplasty over fibrinolysis on reinfarction rate after anterior STEMI diminished during long-term follow-up. |
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Authors:
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Martin Busk; Steen D Kristensen; Klaus Rasmussen; Henning Kelbaek; Per Thayssen; Jan K Madsen; Ulrik Abildgaard; Lars R Krusell; Leif S Mortensen; Leif Thuesen; Henning R Andersen; Torsten T Nielsen; |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2008-11-13 |
Journal Detail:
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Title: Cardiology Volume: 113 ISSN: 1421-9751 ISO Abbreviation: Cardiology Publication Date: 2009 |
Date Detail:
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Created Date: 2009-04-02 Completed Date: 2009-07-14 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 1266406 Medline TA: Cardiology Country: Switzerland |
Other Details:
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Languages: eng Pagination: 72-80 Citation Subset: IM |
Copyright Information:
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Copyright 2008 S. Karger AG, Basel. |
Affiliation:
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Department of Cardiology, Aarhus University Hospital Skejby, Aarhus, Denmark. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Denmark / epidemiology Female Follow-Up Studies Humans Male Middle Aged Multicenter Studies as Topic Myocardial Infarction / etiology*, mortality, pathology Myocardial Reperfusion / methods* Myocardium / pathology* Randomized Controlled Trials as Topic Recurrence |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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